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    The prognostic relationship of 18F-FDG PET/CT metabolic and volumetric parameters in metastatic ALK plus NSCLC
    (Lippincott Williams & Wilkins, 2022) Agüloğlu, Nurşin; Aksu, Ayşegül; Unat, Damla S.; Akyol, Murat
    ObjectiveThe aim of this study is to determine the role of metabolic and volumetric parameters obtained from 18Fluorine-Fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) imaging on progression-free survival (PFS) and overall survival (OS) in patients with advanced nonsquamous cell lung carcinoma (NSCLC) with anaplastic lymphoma kinase (ALK) rearrangement.MethodsPre and post-treatment PET/CT images of the ALK + NSCLC patients between January 2015 and July 2020 were evaluated. The highest standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values were obtained from pre-tyrosine kinase inhibitor (TKI) basal PET/CT (PETpre) and post-TKI PET/CT (PETpost) images. Total MTV (tMTV) and total TLG (tTLG) values were calculated by summing MTV and TLG values in all tumor foci. The change (Delta) in pSUVmax, pMTV, pTLG, tMTV and tTLG before and after treatment was calculated.The relationship of these parameters with OS and PFS was analyzed.ResultstTLG(pre), tMTV(pre), pTLG(pre), pMTV(pre), increment SUVmax, increment tMTV and increment tTLG values were found to be associated with OS; increment tMTV, increment tTLG, tTLG(pre), tMTV(pre), pTLG(pre) and pMTV(pre) were associated with PFS. The cutoff values in both predicting OS and PFS were calculated as -31.6 and 391.1 for increment tMTV and tTLG(pre), respectively. In Cox regression analysis, increment tMTV and stage for OS and increment tMTV and tTLGpre for PFS were obtained as prognostic factors.ConclusionsMetabolic and volumetric parameters, especially TLG values in the whole body before treatment and change in whole body MTV value, obtained from PET/CT may be useful in predicting prognosis and determining treatment strategies for patients with advanced ALK + NSCLC.